With nearly two decades of solid research, most athletes are well versed in the performance benefits of creatine supplementation. But there is more to the story. Emerging research has revealed new and exciting outcomes linked to creatine supplementation. Here’s a recap of creatine as well as new findings that show benefits that extend beyond muscle performance.

Build muscle and strength An unprecedented number of studies have shown that creatine supplementation augments gains in muscle size and strength when taken in conjunction with a resistance-training program. Studies can generally be grouped into short-term and long-term categories. Short-term studies involve a creatine loading phase, usually 15-25 grams per day for 5-7 days, and measured performance before and after supplementation. These studies have shown significant improvement in a variety of exercise tasks.

Lift more reps I performed one of the first short-term studies that assessed lifting performance during a bench press workout. Young, healthy men performed 5 sets of bench press with a load they could lift 10 times. When they came back to perform the same test after one week of creatine loading, they were able to perform 2 more repetitions of bench presses on the first set (12 vs. 10 reps). And over the course of 5 sets, they managed to do an extra 8 reps. This translates into a better training stimulus for inducing gains in muscle.

Increase strength 24% vs. placebo 18% Long-term studies that examined the effects of taking creatine while engaged in a resistance-training program have found consistent benefits on gains in strength and muscle mass. Based on studies I reviewed, the average increases in muscle strength following creatine supplementation plus resistance training are 24% compared to 18% for those taking a placebo. The average increase in maximal repetitions at a given percent of maximal strength following creatine supplementation plus resistance training was 34% compared to 13% for those taking a placebo.

Add 5 pounds of extra muscle In terms of gains in lean body mass, creatine supplementation plus resistance training on average results in about 5 pounds of additional muscle over a 12-week training period. This represents average expected improvements in strength and muscle mass with creatine. In many cases, individuals exceed these average responses, and in some cases there are non-responders to creatine.

Build muscle in your 60s Muscle mass and strength peak between the ages of 20-35, and steadily decline thereafter until the sixth decade of life where a sharp decline occurs. This loss in muscle mass and function adversely affects normal activities of daily living, like getting up from a chair, for many older people.

In one study, women aged 58-71 took 20 grams of creatine per day (divided in 3 equal doses), or a placebo for 7 days. Those who supplemented with creatine showed significant increases in maximal bench press and leg press strength, upper and lower body power, and two functional performance tasks encountered during everyday life (a sit-and-stand test and a tandem gait test). These improvements in functional performance occurred despite no physical training during the 7-day period. No side effects were reported, highlighting the simple yet effective use of creatine to enhance physical performance in older individuals.

The ability of creatine supplementation to promote healthy aging is even more dramatic when combined with resistance training. Canadian researchers had men and women, age 65 or older, perform a supervised resistance training program 2 days per week for 6 months while taking 5 grams of creatine daily or a placebo. After 6 months, the creatine group had a two-fold greater increase in fat-free mass (4.6 pounds) compared to the placebo group (2 pounds). Fat mass was also reduced more in the creatine group (-4.2 pounds) compared to the placebo group (-0.9 pounds).

These human studies are also supported by animal studies. Using an animal model of aging, it was shown that creatine supplementation significantly extended maximum “healthy” life span by 9%. These studies point to creatine as an effective supplement to extend peak performance into your middle years.

Boost brain power Creatine is an important source of energy for cells in the brain that have high metabolic needs required for processes like working and long-term memory. Prior research using sophisticated analytical equipment like magnetic resonance spectroscopy has shown that creatine supplementation results in significant increases in creatine levels in the human brain. Following up on this work, British researchers supplemented adults, average age 76, with 20 grams of creatine daily or a placebo for one week. Subjects completed a battery of cognitive tests that assessed verbal and spatial short- and long-term memory. Creatine supplementation enhanced several of the tests including forward number recall, forward and backward spatial recall, and long-term memory. These findings add to a line of research indicating that creatine supplementation improves cognitive function.

Better glucose control An estimated 1 in 3 adults struggles to maintain a healthy level of blood glucose (blood sugar). In a 12-week exercise training study of type 2 diabetics, those who supplemented with creatine showed a 14% decrease over several weeks in glycosylated hemoglobin (HbA1c), which is a measure of average blood sugar levels. When given a carbohydrate meal, the creatine group showed less of a response in blood sugar and increased glucose transporters on the surface of muscle cells, which translates into greater capacity to take up sugar from the blood. Thus, creatine supplementation led to better control of blood sugar.

What type? How much? There is overwhelming evidence that creatine supplementation enhances exercise performance and helps build bigger muscles in athletes and younger men and women. Recent work has extended these benefits to include increased insulin sensitivity, better glucose control, maintaining strength longer, and improved memory.

In my opinion, the best type is creatine monohydrate. There are other novel forms that claim superior solubility or absorption, but excretion studies show that straight creatine monohydrate is at least 95% absorbed, so there’s not much room to improve upon.

The fastest way to increase muscle creatine is to load with 20 grams per day for 5 days (four 5-gram doses spaced throughout the day). Thereafter, a daily dose of 2-5 grams is all you need to maintain a higher level of muscle creatine.

Jeff Volek is a professor in The Human Performance Laboratory at The University of Connecticut, Storrs, CT. He is an R.D. and has a Ph.D in Kinesiology (Pennsylvania State University). He served on the editorial boards of Nutrition and Metabolism and the Journal of Strength and Conditioning Research. He has published over 250 scientific articles.

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